Direct Demonstration of Preload Dependency of Myocardial Flow Reserve in Human Failing Heart by 15O–H2O Positron Emission Tomography
Direct Demonstration of Preload Dependency of Myocardial Flow Reserve in Human Failing Heart by 15O–H2O Positron Emission Tomography
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通过 15O-H2O 正电子发射断层扫描直接证明人类衰竭心脏中心肌血流储备的前负荷依赖性
DOI：
10.1007/s00547-005-2037-7
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发表时间：
2011
影响因子：
0.6
通讯作者：
M. Kohno
中科院分区：
文献类型：
--
作者：
H. Takinami;Y. Iwado;K. Ohmori;K. Mizushige;Yoshihiro Nisiyama;M. Okawa;C. Kato;N. Tamaki;S. Senda;M. Kohno
虽然充血性心力衰竭（CHF）的心肌血流储备（MFR）已被报道受损，但其机制尚未在人体中完全显示。因此，我们进行了正电子发射断层扫描测量心肌血流量（MBF）在CHF患者，并与血流动力学参数进行了比较。入选16例正常冠心病CHF患者和10例正常对照者。15 O标记的水正电子发射断层扫描在休息时和在高峰充血期间由腺苷三磷酸诱导。MFR计算为充血峰值与基线MBF的比值。所有CHF患者均行心导管检查。CHF患者和正常对照之间的基线MBF相似（0.73 ± 0.25 vs. 0.80 ± 0.12 mL/min/g，p = NS）。充血性心力衰竭患者的充血性心肌血流量显著低于对照组（1.68 ± 1.09 vs.3.21 ± 0.69 mL/min/g，p < 0.05）。CHF患者MFR显著低于对照组（2.30 ± 1.30 vs.4.03 ± 0.90，p < 0.05）。基线MBF与肺毛细血管楔压或左心室舒张末期压之间没有显著相关性，而充血MBF和MFR与肺毛细血管楔压（分别为r =-0.67和r =-0.75）和左心室舒张末期压（分别为r =-0.51和r =-0.60）显著相关。尽管前负荷升高，但CHF患者静息时MBF代偿至与对照组相似的水平。然而，这种补偿可能耗尽衰竭的人类心脏中的血管舒张储备。因此，静息前负荷是心肌血管舒张功能储备的决定因素，减少前负荷可改善CHF患者的冠状动脉血管舒张反应。
Although myocardial flow reserve (MFR) in congestive heart failure (CHF) has been reported to be impaired, the mechanism has not been fully shown in humans. Therefore, we performed positron emission tomography to measure myocardial blood flow (MBF) in patients with CHF and compared it with hemodynamic parameters. Sixteen normal coronary patients with CHF and ten normal controls were enrolled. 15O-labeled water positron emission tomography was performed at rest and during peak hyperemia induced by adenosine triphosphate. MFR was calculated as the ratio of peak hyperemic to baseline MBF. All CHF patients underwent cardiac catheterization. Baseline MBF was similar between CHF patients and normal controls (0.73 ± 0.25 vs. 0.80 ± 0.12 mL/min/g, p = NS). Hyperemic MBF was significantly reduced in CHF patients than in controls (1.68 ± 1.09 vs. 3.21 ± 0.69 mL/min/g, p < 0.05). therefore, MFR was significantly reduced in CHF patients than in controls (2.30 ± 1.30 vs. 4.03 ± 0.90, p < 0.05). There was no significant correlation between baseline MBF and either pulmonary capillary wedge pressure or left ventricular end-diastolic pressure, while both hyperemic MBF and MFR significantly correlated with both pulmonary capillary wedge pressure (r = −0.67 and r = −0.75, respectively) and left ventricular end-diastolic pressure (r = −0.51 and r = −0.60, respectively). Despite elevated preload, MBF at rest in CHF patients was compensated to the similar level as that in controls. However, this compensation may exhaust vasodilatory reserve in the failing human heart. Thus, preload at rest is a determinant of myocardial vasodilator reserve and preload reduction may ameliorate coronary vasodilator response in CHF patients.
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扩张型心肌病患者的冠状血管舒张能力受损。
DOI：
--
发表时间：
1996
期刊：
American journal of cardiac imaging
影响因子：
--
作者：
Weismüller,S;Czernin,J;Sun,KT;Fung,C;Phelps,ME;Schelbert,HR
通讯作者：
Schelbert,HR
冠状血管机制涉及从肥厚到心力衰竭的失代偿。
影响因子：
24
作者：
Vatner,SF;Hittinger,L
通讯作者：
Hittinger,L
影响因子：
37.8
作者：
TREASURE, CB;VITA, JA;GANZ, P
通讯作者：
GANZ, P
影响因子：
2.4
作者：
JAN, KM
通讯作者：
JAN, KM